More than 65% of the Indian population is below the age of 35. And all those who get married eventually might have kids. So, every family will have to bear maternity expenses. Most of the people are unaware of the fact that health insurance policies provided by the employer might not cover all maternity expenses. Even if it does, the amount might not exceed Rs 50,000. Maternity expenses, as you might know, could amount to much more than that.
The cost of a normal delivery at a private hospital could range anywhere between Rs 60,000 and Rs 1 lakh. If it is a caesarean section, the cost could go up to Rs 2 lakh and more. This includes the cost of hospitalisation, surgery charges, medication charges and other such expenses. That is why getting a maternity cover might be important.
What is a maternity cover?
Maternity cover is an insurance cover that helps you meet expenses when your child is delivered. It will cover both normal as well as caesarean section delivery. This is not available as a separate policy. It is often provided as an add-on to your health insurance policy. Why? Insurance is a plan that covers possible risks. Since maternity could be a certain event, the plan is offered as an add-on and not as a separate plan.
What is covered?
You will have expenses that are incurred before hospitalisation, during hospitalisation and after hospitalisation. Most maternity plans cover all these expenses. Pre-hospitalisation expenses could include scan charges, medication and other expenses. Post hospitalisation expenses can include consultation and other charges. Pre-hospitalisation expenses are usually covered up to a month before the policyholder is admitted to the hospital. Post-hospitalization expenses can be covered up to a month or two after the policyholder is discharged from the hospital. While in the hospital, the policyholder might incur room charges, nursing charges, medication charges and other such expenses. Maternity plans could work on a reimbursement basis or could be cashless.
Apart from delivery expenses, most maternity plans cover post-delivery complications too. The expenses related to treating your newborn baby will also be covered under the maternity policy. This could include congenital diseases and other illnesses. If vaccinations are covered it might be beneficial because each vaccination could cost you anywhere between Rs 5,000 and Rs 10,000. Some even provide the list of vaccinations that are covered.
How much is covered?
If you have a Rs 10 lakh cover, you could get a maternity add-on for Rs 50,000 – Rs 60,000. If the sum assured for your health insurance plan is lower, your maternity add-on cover sum assured will also be lower. You also have the option of co-pay in these plans where you pay a part of the expenses.
What’s the tenure?
Most maternity plans need you to wait 2-3 years before you can claim expenses. This means that you will have to get a cover as soon as you get married even if you are not planning to have a kid anytime soon. However, note that there are policies like Religare’s maternity policy where the maternity wait period is 9 months and 24 months. The initial waiting period for these plans is just 30 days.
Maternity plans have a lot of exceptions. Expenses incurred for voluntary termination of pregnancy or ectopic pregnancy are not covered by maternity policies. Complications due to existing congenital diseases might not be covered in some cases.
It is important to read the terms and conditions of the policy before you buy the maternity add-on. Check the coverage given by your employer and then you could choose a policy with the sum assured that you need. It is best to have some savings in place even if you have a maternity plan because there might be rejections of claims in certain cases. Keeping cash on hand can help you meet expenses which your plan might not cover.